§ 820.1 Legal basis. Adds sections 2771 and 2181 of the Public Health Law relating to HIV and Hepatitis-C testing.

§ 820.5(a) and (b) General Program Standards. Adds reference to HIV and Hepatitis education and prevention; adds generic term for Narcan (naloxone).

§ 820.6(c) and (d) Staffing. Requires all clinical staff be provided with and document specialized training in identified areas; regarding HIV and AIDS, clarifies the duties of a Health Coordinator to provide information about both pre- and post-exposure precautions.

§ 820.7(b) Assessment. Requires all patients be offered Hepatitis testing, either on site or by referral, as soon as possible after admission; conforms provisions related to offer of HIV-AIDS testing to current Public Health Law; requires consultation with prescriber prior to modifying HIV prophylaxis medications. Clarifies that significant medical issues which must be addressed in a treatment/recovery plan include risk for communicable diseases.

§ 820.12(b) Admission criteria. Renumbering.

The proposed rule amends Part 820 to mandate the offer of HIV/AIDS and hepatitis testing, in accordance with public health law. The state has a broad public health interest in ensuring that individuals are tested for HIV and Hepatitis, especially those individuals at increased risk, who routinely access addiction treatment services. This rule will not impact technology, economic conditions or other factors as these programs are already screening individuals admitted to their programs for HIV and Hepatitis risk. The proposed amendment will provide a universal system for all providers to offer the testing, onsite or by referral, and make such notation in the patient chart.

1. Statutory Authority:

(a) Section 19.07(e) of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt standards including necessary rules and regulations pertaining to chemical dependence services.

(b) Section 19.09(b) of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt regulations necessary and proper to implement any matter under his or her jurisdiction.

(c) Section 19.40 of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to issue operating certificates for the provision of chemical dependence services.

(d) Section 32.01 of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt any regulation reasonably necessary to implement and effectively exercise the powers and perform the duties conferred by article 32 of the Mental Hygiene Law.

(e) Section 32.07(a) of the Mental Hygiene Law authorizes the Commissioner of the Office of Alcoholism and Substance Abuse Services to adopt regulations to effectuate the provisions and purposes of article 32 of the Mental Hygiene Law.

(f) Section 2171 of the Public Health Law defines the rules governing Hepatitis-C testing in New York.

(g) Section 2781 of the Public Health Law defines the rules governing HIV testing in New York.

2. Legislative Objectives: The Proposed Rule Amends Part 820 to mandate the offer of HIV/AIDS and hepatitis testing, in accordance with the Public Health Law. The state has a broad public health interest in ensuring that individuals are tested for HIV and Hepatitis, especially those individuals at increased risk and who routinely access addiction treatment services.

3. Needs and Benefits: This regulation responds to changes in the Public Health Law which require the offer of an HIV test. The Public Health Law also mandates the offer of a Hepatitis-C test for individuals born between 1945-1965. Given the nature of the services provided to those populations served by OASAS, the majority of individuals served are at-risk and therefore an offer of HIV and hepatitis testing will be mandated for all individuals admitted to residential settings. Testing for both hepatitis and HIV may be done on-site or by referral. The proposed amendments are in accordance with OASAS residential programs providing integrated behavioral health and physical health service delivery models of care.

4. Costs: The Office anticipates no fiscal impact on providers or local governments, job creation or job loss, because the provisions require an offer of testing which may be conducted on-site or by referral if testing cannot be conducted on-site.

5. Paperwork: The proposed regulatory amendments will not require additional paperwork because residential treatment providers would utilize existing treatment planning and discharge administrative processes.

6. Local Government Mandates: This regulation imposes no new mandates beyond those already existing in statute on local governments operating certified OASAS residential programs or local governments whose jurisdiction includes a residential facility.

7. Duplications: This proposed rule does not duplicate any state or federal statute or rule.

8. Alternatives: No alternatives. HIV and hepatitis testing is in conformity with the Public Health Law.

9. Federal Standards: These amendments do not conflict with federal standards.

10. Compliance Schedule: These regulations will be effective upon publication of a Notice of Adoption in the State Register.

OASAS has determined that the rule will not impose any adverse economic impact or reporting, recordkeeping or other compliance requirements on small businesses or local governments. This rulemaking proposal has been reviewed and approved (April 24, 2017) by the Behavioral Health Services Advisory Council consisting of affected OASAS providers of all sizes from diverse municipalities, and including local governments. The proposal is supported by providers because it conforms HIV and Hepatitis testing with current Public Health Law.

OASAS has determined that the rule will not impose any adverse impact on rural areas or reporting, recordkeeping or other compliance requirements on public or private entities in rural areas. This rulemaking proposal has been reviewed and approved (April 24, 2017) by the Behavioral Health Services Advisory Council consisting of affected OASAS providers of all sizes form diverse municipalities, and including local governments. The proposal is supported by providers because it conforms HIV and Hepatitis testing with current public health practice and the Public Health Law.

OASAS is not submitting a Job Impact Statement for this rulemaking. OASAS does not anticipate a substantial adverse impact on jobs and employment opportunities because the requirements for this service are already met by certain staff operating in certified residential programs.